Abstract

Tendinopathies are common clinical pathologies leading to local disability and impaired athlete's performance. A diagnosis of tendinopathy is based on local symptoms under physical load and pain on tendon palpation. To verify structural alterations of the tendon, ultrasound and/or MRI examinations are useful. Basically, any tendon can be affected. However, highest rates of tendinopathy are seen in the Achilles and patella tendons of athletes. Sport-specific accumulation of complaints is usually explained by regionally higher tendon loading leading to intratendinous micro ruptures, with loss of hierarchical collagen fibre organisation.Non-surgical treatment is recommended as the initial strategy in tendinopathies at all locations. In general, the treatment approach is multifactorial and consists of both exercise and physical therapy. Different methods aim to stimulate collagen synthesis, reduce tissue adhesions and free nerve endings, as well as optimising the stress onto the tendon by improved load management. As a result of recent evidence, it can be stated that eccentric training regimens lead to favourable results with less pain and improvement in function within 12 weeks of application. Shock wave and laser therapy show promising results on pain reduction at some locations. Systemic or local usage of medication has to be considered as an additional, practically relevant therapeutic tool without significant evidence for use in athletes. Location-wise modification of treatment strategy has to be undertaken.